Prevalence of Anxiety, Depression, and Attention Deficit Disorder in 
Patients with Primary Hyperhidrosis

• Primary hyperhidrosis is a chronic 
and socially disabling disorder 
with a significant impact on quality 
of life. 

• It has an estimated US prevalence 
of 4.8% (~15.3 million people).1

• Few studies have attempted to 
estimate the prevalence of mental 
illness in patients with 
hyperhidrosis, and the results 
have been conflicting.2-5

• Estimate the prevalence of 
depression, anxiety and attention 
deficit disorder (ADD) in patient was 
primary hyperhidrosis.

• Understand the correlation between 
hyperhidrosis location and severity 
with mental health

• 500 patients included
• 13.8% of patients had a diagnosis of anxiety, 

12.4% had depression and 6.4% had ADD 
• Positive correlations between the number of 

anatomical HH sites involved and the 
prevalence of psychiatric conditions 

• no association with overall HDSS severity or 
location involved with prevalence of psychiatric 
conditions. 

• There is a significant association between HH 
and the prevalence of anxiety, depression and 
ADD regardless of gender or age 

• Compared to the nationally reported 
prevalence of anxiety (5.7%)6, depression 
(7.8%)7 and ADD (4.4%) 8, HH patients have a 
statistically significant higher prevalence than 
the general public. 

• Our study found the prevalence of anxiety 
13.8%, Depression 12.4% and ADD 6.4%

• The severity and/or location of HH do not 
correlate with prevalence of anxiety, 
depression and ADD. 

• However, there is a positive correlation 
between the number of anatomical sites 
involved and the prevalence of these 
comorbidities. 

• Providers should be aware of the increased 
prevalence of mental health disorders in 
patients with hyperhidrosis. 

• An IRB approved retrospective review:
• Patients diagnosed with primary hyperhidrosis 

from 2011-2018 at a single site were identified 
at time of initial evaluation. 

• Age of onset, age at time of initial evaluation, 
gender, hyperhidrosis locations and disease 
severity using Hyperhidrosis Disease Severity 
Scale (HDSS) were recorded

• HDSS was used as a maker of location 
severity.

• Patients were considered to have anxiety, 
depression, and/or ADD diagnosis if: (1 or 
more)

• self reported diagnosis on intake form
• had an ICD9 code of diagnosis clinical 

note documenting diagnosis
• taking ADD specific medication

1. Doolittle et al. Arch Dermatol Res. 2016;308(10):743-9.
2. Bahar R, Liu Y, Huang Y, et al. The prevalence of anxiety and depression in patients with or 

without hyperhidrosis (HH). J Am Acad Dermatol. 2016;75:1126-1133
3. Braganca GM, Lima SO, Pinto Neto AF, Marques LM, Melo EV, Reis FP. Evaluation of 

anxiety and depression prevalence in patients with primary severe hyperhidrosis. An Bras 
Dermatol. 2014;89:230-235.

4. Weber A, Heger S, Sinkgraven R, Heckmann M, Elsner P, Rzany B. Psychosocial aspects of 
patients with focal hyperhidrosis. Marked reduction of social phobia, anxiety and depression 
and increased quality of life after treatment with botulinum toxin A. Br J Dermatol. 
2005;152:342-345

5. Klein SZ, Hull M, Gillard KK, Peterson-Brandt J. Dermatology and Therapy, 2020;10:1299-
1314

6. Harvard Medical School National Comorbidity Survey (NCS). 2017
7. National Survey on Drug Use and Health (NSDUH) 2019
8.     Kessler RC, Adler L, Barkley R, Biederman J, Conners CK, Demler O, Faraone SV, Greenhill 
LL, Howes MJ, Secnik K, Spencer T, Ustun TB, Walters EE, Zaslavsky AM. The prevalence and 
correlates of adult ADHD in the United States: results from the National Comorbidity  Survey 
Replication. Am J Psychiatry. 2006 Apr;163(4):716-23.

Methods

Objective

Results

Conclusion:

Ella Glaser MD1, King Rosemary PA-C2, Dee Anna Glaser MD2
1University of Miami Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery 2Saint Louis University Department of Dermatology

References:

Synopsis
Psychiatric
Diagnosis

Prevalence (%)

Anxiety 13.8

Depression 12.4

Attention Deficit Disorder 
(ADD)

6.4

Characteristic Value
Total number of patients 500

Age:

Mean age of onset 15

Mean age at time of 
evaluation

30

Sex Number (%)

Female 356 (71.2)

Male 144 (28.8)

Number of sites involved

1 to 3 307 (61.4)

4 to 6 124 (24.8)

7 to 9 69 (13.8)

Dr. Dee Anna Glaser is a consultant for Dermira, Inc., and an 
investigator for Allergan, Atacama Therapeutics, Brickell Biotech, 
Inc., Galderma, and Revance Therapeutics, Inc. She has received 
honoraria for consulting with Allergan and Dermira, Inc. 

Disclosures